2022 Enrollment Guide

2022 Enrollment Guide

Your Pre-Medicare guide to funding and medical plan options

September 2021

We're Here to Assist You

OPERS has partnered with Via Benefits Insurance Services (Via Benefits) to serve as your Pre-Medicare Connector. We are looking forward to supporting you now and in the future through the services we provide.

9 Ensuring you understand your funding options and administering the OPERS Health Reimbursement Arrangement (HRA)

9 Helping you find and enroll in a new individual or family medical plan

9 Offering support and guidance throughout the year Via Benefits makes it easy to use our services. You can sign into our website, speak to a licensed benefit advisor on the phone, or a little of both. You decide what works best for you. Here's how to contact us:

Online marketplace.opers

By Phone 1-833-939-1215 (TTY: 711) Monday through Friday, 8:00 a.m. to 9:00 p.m. Eastern Time

Go to marketplace.about/privacy-policy to access our privacy policy. If you have questions or concerns, please contact us.

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Call us: 1-833-939-1215 (TTY: 711)

Table of Contents

Who Is Via Benefits? 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Your Funding Options 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Your New Medical Plan 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Three Steps to Enrollment 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . After Enrollment 42 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Frequently Asked Questions (FAQs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Schedule your enrollment appointment

If you haven't already, go online to marketplace.opers or call Via Benefits at 1-833-939-1215 (TTY: 711) to schedule your enrollment appointment. These appointments should happen any time during the Open Enrollment Period, which is November 1, 2021, through December 15, 2021.

711724-041221-OPERS_PMCR_EnrollmentGuide_EG_48

Go online: marketplace.opers

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Call us: 1-833-939-1215 (TTY: 711)

Who Is Via Benefits?

Via Benefits is a service that helps you understand and navigate your individual and family medical plan options. We're not a health insurance carrier, but rather an unbiased resource that will help you evaluate your choices. Think of us as your "coach" ? offering advice and guidance regarding your funding arrangement and medical plan options throughout all the stages of your retirement.

Via Benefits operates a health insurance marketplace that offers a wide range of medical plans from the nation's leading health insurance carriers. The marketplace includes plans that are on , as well as many other standalone plans, and plans that are offered through state-based exchanges. You can access our insurance marketplace by going to our website, speaking one-on-one with licensed benefit advisors in our US-based call center, or a little of both.

Via Benefits is also the administrator of the OPERS Health Reimbursement Arrangement (HRA). We review and process your reimbursement requests, ensuring you get timely reimbursement for eligible expenses. You can manage your OPERS HRA easily on our website or mobile app.

Lastly, Via Benefits is your year-round advocate. Our team is available to support you with all types of issues and questions. From helping you evaluate your funding options, to working with you to understand and enroll in the right medical plan, to assisting you when you have matters to resolve with your provider, insurance carrier, or OPERS HRA, we're here to assist you!

Go online: marketplace.opers

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Your Funding Options

OPERS provides funding to you through a Health Reimbursement Arrangement (HRA). The OPERS HRA is an account you can use to request reimbursement for any eligible post-tax expenses you and your eligible dependents incur.

The HRA is funded by a monthly contribution from OPERS and is administered by Via Benefits. If you are eligible, you can find your OPERS HRA contribution amount on the letter that came with this guide or on your OPERS online account.

Depending on income level, some individuals may also be eligible for subsidies from the federal government in the form of a Premium Tax Credit (PTC) and/or a Cost Sharing Reduction (CSR). By law, you can't accept the OPERS HRA and get a PTC or CSR at the same time. If you're eligible for both, you'll need to decide which type of funding support works best for you. See page 9 for more details, and remember, we can help you evaluate your options.

To have access to the OPERS HRA in 2022, you must make your funding decision and accept the HRA by contacting Via Benefits between November 1, 2021 and December 15, 2021. You can opt in by contacting Via Benefits by phone or by signing into the Via Benefits website. From the My Account page, select Manage decision located beneath Your Funding Decision. There you will also see if you qualify for a PTC or CSR.

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Call us: 1-833-939-1215 (TTY: 711)

What happens after you opt in to the OPERS HRA

Via Benefits will establish your OPERS HRA and become the administrator of your account. This means we'll process your reimbursement requests, help resolve issues, answer your questions, and more. There is a monthly fee of $2.60 for administration of the OPERS HRA, which will be withdrawn from the account each month.

Unlike the OPERS Pre-Medicare group plan, monthly premiums for your new plan in 2022 will not be deducted from your pension benefit. You must pay your premiums and out-of-pocket expenses first and then request reimbursement from your OPERS HRA. Once your request is approved, the money will transfer from your OPERS HRA into your personal bank account.

OPERS requires that you receive any reimbursements from your HRA by direct deposit. This means you must provide bank account information to Via Benefits to receive your reimbursements. As a convenience to you, OPERS provides Via Benefits with the bank account information in which you receive your monthly pension benefit, but if you need to add or update your bank account information, you can do so on our website or by mail. More information on how to set up direct deposit will be provided after you opt in to the OPERS HRA.

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You opt in to the OPERS HRA

OPERS makes a monthly

contribution to your account

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You pay for your premiums and other eligible

expenses

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Via Benefits approves your request and reimburses you

You request reimbursement

Go online: marketplace.opers

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Via Benefits makes it easy to manage your OPERS HRA

Reimbursing yourself from your OPERS HRA is safe, quick, and easy when you use Via Benefits' online tools or mobile app.

After you accept your funding by opting in to the OPERS HRA, you'll receive a Getting Reimbursed Guide in the mail containing more details. The guide will include instructions on accessing your account, how to submit expenses for reimbursement, and a list of eligible expenses. You can find additional educational resources on under the Retired Members menu by selecting Education Resources. In the meantime, if you have questions, a Via Benefits representative will be happy to answer them.

When you become Medicare-eligible

As a Pre-Medicare Benefit Recipient, you are not required to enroll in a medical plan through Via Benefits to receive contributions to your OPERS HRA or receive reimbursements. However, you will be required to do so once you become Medicare-eligible. This is a good reason to begin your relationship with Via Benefits now.

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Call us: 1-833-939-1215 (TTY: 711)

Deciding between the OPERS HRA and a federal subsidy

Depending on your income level, you may be able to lower your monthly costs if you qualify for a federal subsidy in the form of a Premium Tax Credit (PTC) or Cost Sharing Reduction (CSR). If you qualify, you will need to decide whether it is more advantageous to you to accept your funding from OPERS by opting in to the HRA or by taking a federal subsidy. By law, you are not allowed to have an HRA and federal subsidy at the same time.

Via Benefits can help you understand the difference between your funding options and help you make your selection.

What is a Premium Tax Credit (PTC)?

A tax credit that lowers your monthly premium. It is based on both household income and family size, and is paid by the government directly to the health insurance carrier.

What is a Cost Sharing Reduction (CSR)?

A feature of certain plans that lowers what you pay in out-of-pocket costs like deductibles, copayments, and coinsurance. If you qualify, you can get these extra savings only if you enroll in a plan from the Silver category. (See page 24 for Silver plan details.)

Go online: marketplace.opers

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